1. Field of the Invention (Technical Field)
The invention described and claimed herein is generally related to an upper extremity or arm supportive sling or apparatus. More specifically, this invention is related to an upper extremity supportive apparatus that provides support and protection to the flaccid upper extremity of the human body.
Cerebral vascular accident (CVA) is a devastating event that brings with it a wide variety of impairments. The deficits arising from even a small CVA can affect every system in the body. Physically, the most noticeable system affected is the musculoskelatal system. Following CVA, the muscles of the involved side have the daunting task of functioning with an altered nervous system. Rehabilitation is often frustrating and functional returns may be minimal. Nowhere is this seen or felt more than in the upper extremity.
A flaccid or low tone upper extremity is a common finding in individuals following a CVA, and its rehabilitation is crucial in the recovery process. A flaccid upper extremity presents a challenge to the treating therapist because the protection necessary for the extremity involved often hinders its functional return.
Upper extremity positioning and slings are often used to protect the upper extremity. There are several different ambulatory upper extremity supports used in stroke rehabilitation. All of these slings are designed to support the arm, but few actually reduce subluxation and none of them support the arm in a functional position. Therefore, support of the hemiplegic limb while in the upright position remains controversial.
2. Background Art
Note that the following discussion refers to a number of publications by author(s) and year of publication, and that due to recent publication dates certain publications are not to be considered as prior art vis-a-vis the present invention. Discussion of such publications herein is given for more complete background and is not to be construed as an admission that such publications are prior art for patentability determination purposes.
Approximately 600,000 individuals are diagnosed with cerebral vascular accidents (“CVA”) annually in the United States. Many of these individuals have temporary or permanent hemiparesis. In addition to the obvious loss of function on the involved side, these individuals run the risk of mechanical injury to the involved upper extremity in addition to the deficits resulting from the neurological insult of the CVA, including damage to the rotator cuff musculature and associated cognitive neglect, and damage to the shoulder and arm resulting from external forces to an unprotected and uncontrolled flaccid arm. In addition, positioning of the flaccid arm for long periods of time (commonly, internal rotation at the shoulder by placing forearm across stomach) can result in shortening of the soft tissue crossing the joint, resulting in significantly reduced joint range of motion. This is an absolutely tragic situation for those who experience eventual return of motor function in the upper extremity.
The above mentioned risks of mechanical injury to the involved upper extremity are easily controlled with proper support and positioning while the individual is seated. While performing standing tasks and ambulating, the same risks can be effectively controlled with the skill of a well-trained therapist and assistive devices. As the individual progresses toward independent function, the controls on the risks of mechanical injury are lost. Products on the market today do not effectively control all the above mentioned risks to mechanical injury to the involved flaccid upper extremity once the individual is progressing toward independent function.
The following are slings available in the prior art. However, these slings do not provide appropriate positioning or control of a flaccid upper extremity.
The Harris Hemi-Arm Sling is a sling centered at the front part of the body. This sling holds the arm in an inappropriate position for a flaccid upper extremity.
The AliMed Hemi Shoulder Sling, U.S. Pat. No. 5,403,268, is a sling with a shoulder harness and upper arm portion. The sling is complicated to put on; and the arm cuff is intended to reduce subluxation, but instead it creeps up the arm and is ineffective. Further, it lacks distal arm control and does not hold the arm in a functional position.
The Shoulder Saddle sling, sold by AliMed, Inc., provides a shoulder harness and a lower arm portion. However, the cuff on the lower arm portion rides up on the arm and does provide effective reduction of shoulder subluxation. Further, it does not provide a weight-bearing member for the wrist and hand and does not control the elbow and wrist joints.
U.S. Pat. No. 4,834,082 entitled “Arm Sling for Stroke Patients,” to Ghadiali, is directed to an arm sling with a back shoulder harness. This sling holds the arm in an inappropriate position for a flaccid upper extremity.
U.S. Pat. No. 4,716,895, entitled “Arm Sling,” to Marques et al., has a shoulder portion, an upper arm portion and a lower arm portion. It further has an attachment to the user's belt. This sling holds the arm in an inappropriate position for a flaccid upper extremity.
U.S. Pat. No. 5,857,990, entitled “Orthopedic Garment for Dynamic Scapular and Acromio-Clavicular Stabilization, Including Dynamically Enhancing Proper Posture,” to Maas; U.S. Pat. No. 5,628,725, entitled “Shoulder Stabilizer Methods,” to Ostergard; and U.S. Pat. No. 6,106,493, entitled “Shoulder Stabilizer,” to Rozell; are all directed to shoulder sling systems. These slings are used for orthopedic problems; are not designed to reduce neurological subluxation; do not facilitate neurological return; and do not control a flaccid upper extremity in a functional position.
U.S. Pat. No. 4,598,703, entitled “Hemi-Arm Sling,” to Lindemann, is directed to a sling with a shoulder harness and an upper arm portion. This sling is complicated to put on; the arm cuff, which is intended to reduce subluxation, actually creeps up the arm and is ineffective; it lacks distal arm control; and there is no control of functional arm position.
U.S. Pat. No. 3,815,588, entitled “Apparatus and Methods Relating to Support of the Forearm,” to Klausner, is directed to a sling with a shoulder portion and a lower arm and hand portion. The sling does not hold the arm in an appropriate position for a flaccid upper extremity.
U.S. Pat. No. 5,203,763, entitled “Dynamic Sling,” to Lajiness-O'Neill, is directed to a shoulder support and two opposing upper arm supports. It does not hold the arm in an appropriate position for a flaccid upper extremity nor does it provide for weight bearing wrist and hand control.
The present invention, in contrast to the prior art, provides proper positioning for a flaccid upper extremity; holds the arm in a functional position; provides effective reduction of neurological subluxation; provides a weight bearing member for the wrist and hand; controls the elbow and wrist joints; facilitates neurological return; and is easy to put on and adjust and use.